Can prednisone raise blood pressure?

Yes, one of the more common and possible side effects of prednisone is an increase in blood pressure. Two ways in which prednisone may raise your blood pressure are through fluid retention and weight gain.

Prednisone stimulates receptors in your kidneys to retain excessive sodium and water. This increases the total volume of blood that is being pushed by the heart and thus raises blood pressure.

Prednisone can also increase blood pressure through weight gain. It mimics cortisol in the body to change metabolism and increase appetite. An increased appetite can lead to excess calorie intake and eventually weight gain.

If you already have hypertension (high blood pressure), taking prednisone may worsen blood pressure control. Your doctor may adjust your medication or recommend monitoring your blood pressure to assess your body's response to prednisone.

The prevention and treatment of prednisone-induced hypertension include being prescribed the lowest effective dose for your condition, lifestyle or diet changes, and the use of certain medications.

Minimal effective dose

Side effects are known to be more common in patients receiving glucocorticoids, such as prednisone, in high doses or over a long period. Hence, the smallest dose that works and the shortest length of treatment can help reduce your risk of developing high blood pressure.

Your health care provider may also have you:

• Skip your dose of prednisone every other day
• Start with a high dose or prednisone initially, then taper the dose down.

Related questions

• What is considered a high dose of prednisone?
• What's a good prednisone taper schedule?
• Is it OK to drink alcohol with Prednisone?

Lifestyle changes

Lifestyle changes can help manage high blood pressure.

Eating a balanced diet of fiber-rich foods like fruits, vegetables, whole grains, protein, and healthy fats can help with maintaining a healthy weight. Drinking water can also help curb appetite, and exercising will help expend some of the calories.

A diet low in sodium (no more than 1,500 mg a day for most adults, as per the American Heart Association recommendations) can help reduce fluid retention. Some tips to achieve this include:

• Avoiding high-sodium foods such as canned and processed foods, soy sauce, cold cuts, or chips
• If canned foods are necessary, choose those labeled “low sodium” or “no salt added." Make sure to rinse off the extra salt used to preserve the food before consuming it
• Keep saltshakers off the table and avoid adding salt after cooking meals.

Blood pressure medications

If you develop high blood pressure while taking prednisone, your health care provider may recommend starting blood pressure medication. A class of medications called diuretics may be used to treat prednisone-induced hypertension. They work by increasing electrolyte and water elimination in the kidneys.